NCG080712_MONITORING INFO_20190831

Fi"o
STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
DOC TYPE
❑ HISTORICAL FILE
E�MONITORING REPORTS
DOC DATE
❑ D O I
YYYYMMDD

for North Carolin
CERTIFICATE OF
FACILITY NAME
COU NlY —f,9
PERSON COLLEC
on sa
a
Lab Cert. #
NCG080000
O!a?%lr PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new oil per month? X yes ❑ no if es complete Part A)
Part A: Vehicle & Equipment Maintenance Areas Monitoring Requirements (if applicable) 50 No discharge this period
OutfaliNo
8enchinarlcs_
Parameter code
-Aate�Sam le Collected'
_ p
=�. (mo/dd/yri
-
24-hour rainfall amount,
-
- `Inches' _.
a
46529 .:
Non Polar Oil Grease
.,.,r ,..
mg/L ; :.-.
is .
..- ' ,- :..
--00552.: �
d Solids
Total Suspended
4
'..mg%.�o'
00 or
;. i 30-,
GOS
New MotoroHymroa�uhc Oil Usage,
...
_
. NCOIL
e 4—. r„r fho camp
nnrameter at the same outfall.
Monthly sampling (instead of semi-annual) must oegin with the secunu wi �_ •_
Permit Date: 11/1/2018-5/31/2021
SWU-248, last revised 11/1/2018
Page 1 of 2

Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals (If applicable) No discharge this period2
Autfally
Date Sample ;
37Ahour rainfall
Sample Collected'
Total Suspended'it
pH°, t
x Non'Polar Od $'
No'� '
mo/dd/Yr U s
ym mhdi
-
5 and untt
Grease; X54,
mo/dd/yr) `"
Inches3 x.
.-
yx �,
�
`PemiifLtmft
'� `
"
�:afsu5✓
'"
0�,50° s
6 0 0:.
W �^.«�,i.15?u '.
r- am
�z'svl
$o4�xihz..s.'
.100 n
�9 �n.s..,
PorameterCode...:.,.�,".'.�....Y:.,sv
x
...,. 46629.
:_ w �ws,xo
.,, r:.;, > C0530�ia x ..,,.
`L.00400�' ......k..
0U552;.',.�;,r
Footnotes from Part A also apply to this Part B
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
FOR PARTA AND PART B MONITORING RESULTS:
A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B.
TIER 3: HAS YOUR FACILITY HAD 4OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO rl
IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE? YES © NO 0
REGIONAL OFFICE CONTACT NAME:
Mail an original copv of this DMR, including all "No Discharge" reports, within 30 days of receipt of the lab results for at end of monitorina period in the
case of "No Discharge" reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I
am aware that there are significant pen ' s for submitting false information, including the possibility of fines and imprisonment for knowing violations."
of
Permit Date:11/1/2018-5/31/2021
Date
SWU-248, last revised 11/1/2018
Page 2 of 2

STORMWATER DISCHARGE OUTFALL (SDO)
ANNUAL SUMMARY DATA MONITORING REPORT (DM / S Annual Update DATA REVIEW FORM
Calendar Year o
Individual NPDES Permit No.
Certificate of Coverage (COC) No.
or
This monitoring report summary of the calendar year should be kept on file on -site with the facility SPPP.
Facility Name:
County: GG
Phone Numbe
Total no. of SDOs monitored
Outfall No.
Is this outfall currently in Tier 2 (monitored monthly)?
Was this outfall ever in Tier 2 (monitored monthly) during the past year?
If this outfall was in Tier 2 last year, why was monthly monitoring discontinued?
Enough consecutive samples below benchmarks to decrease frequency ❑
Received approval from DWQ to reduce monitoring frequency ❑
Other ❑
Was this SDO monitored because of vehicle maintenance activities?
Yes o No ❑
Yes ❑ No DO
Yes IXI No
Lasr M"SEO WU 1i u10

Additional Outfall Attachment
Outfall No.
Is this outfall currently in Tier 2 (monitored monthly)? Yes ❑ No ❑
Was this outfall ever in Tier 2 (monitored monthly) during the past year? Yes ❑ No ❑
If this outfall was -in Tier 2 last year, why was monthly monitoring discontinued?
Enough consecutive samples below benchmarks to decrease frequency ❑
Received approval from DWQ to reduce monitoring frequency ❑
Other ❑
Was this SDO monitored because of vehicle maintenance activities? Yes ❑ No ❑
' -
5
�
Total
inches
� r
-,. ' �.•..
, Paremeter,-(unrts)�
<?a s F � -'�.
,� �
� �� ?,
r .fib Yvs
Nfi�,..
=. '�
r
fa d
WY ,
Benchmark '",--:N/A•,
s ;•
Date Sample
= -
Mott-
SWU-264

" I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a
system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person
or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the
best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information,
including the possibility of figas�an�,irfprisonment for knowing violations."
Date
For questions, contact your local Regional Office:
DEMLR Regional Office Contact Information:
;4._SIi�',Ili GI6 .OETI_1,
,E -. =RE. ALSO Cn
O - - -- ,-' 61+1`AI;A C
2090 US Highway 70
225 Green Street
610 East Center Avenue/Suite 301
Swannanoa, NC 28778
Systel Building Suite 714
Mooresville, NC 28115
[phone]
Fayetteville, NC 28301-5043
[phone]
[phone]
_
gp PA1R IONA 'O ' C
_
G, 1REG'�O - OF,
i (:eTO . , -U _
1 127 Cardinal Drive Extension
3800 Barrett Drive
943 Washington Square Mall
Raleigh, NC 27609
Washington, NC 27889
Wilmington, NC 28405-2845
[phone]
[phone]
[phone]
S • - -S" 'QI'+ A) CE
C-E �Oiar,:rGE
1617 Mail Service Center
450 Hanes Mill Rd, Suite 300
Winston-Salem, NC 27105
Raleigh, NC 27699-1617
[phone]
[phone]
I _
SWU-264 - Generic Annual DMR
Last revised 610112018

(� I
Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Energy, Mineral and Land Resources General Permit No. NCGO80000
Date submitted
CERTIFICATE OF
FACILITY NAME
COUNTY
PERSON COLLEC
LABORATORY M/C�d,P G Lab Cert. #
Comments on sample collection or analysis:
SAMPLE COLLECTION YEAR ,0�74�2
SAMPLE PERIOD ❑ Jan -June WJul
or I
REEPWITUO
AUG 12 N19
QWater Supply
CENT kAL FILES PLEASE REMEMBER TO SIGN ON THE REVERSE a
DWR SECTION
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new oil per month? Mt yes []no if es complete Part A)
Part A: Vehicle & Equipment Maintenance Areas Monitoring Requirements (If applicable) ❑ No discharge this period'
d) ll r G)i1
Outfall No.
Benchmarks
Parameter [ode.
Li
%%
:OateSample Collected'
:c'
�' 0 ' --
24-hour iainfall amount,
;•,inches' ':-.,
-Nori Polar oil &Grease
`� - trig/L
.>� 15 __
00552i.
Total Suspended Solids,
.; '>mg'/L _ .gig
100 or 504
,� .00530
New Motoru� Hydraulic Oil Usage,
..gal/mon
O.�
NCOIL
...
he
Permit Date: 11/1/2018-5/31/2021
SWU-248, last revised 11/1/2018
Page 1 of 2

Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals (If applicable) ❑ No discharge this period'
06tl!0 ' Date Sample F 24�ho6rramfall'% Sample Collected' Total Suspended Wdw
pH s, i Non Polar Oil &
allo v� Qt "Collected' '� amount, mo/dd/yr "^,� ^� ' Solids, `I k Standard units �' . Grease
x SXz i.. '� ;.y :F t .S�r'<c.j, / z^.�''"Y�',`^ii `'` z TY'.n d✓�.'Y vd hS« x' k�
,v rz Y,.•aa �• "em s ° s-_�lrtio/dd/Yrk^' .....,._:Inches;'. , _..x mglL, .v�. i,- n :; mlix
9 0
Poranie- Code " ? �"�" k ,:„ `,46529 ;R sru'aS "::" xf l : - , COS30" ,009' '-" .0055T 717-7"
Q s
Footnotes from Part A also apply to this Part B
Note: If you report a sample value in excess of the benchmark, you must implement Tfer 1, rer 2, or Tier 3 responses. See General Permit text.
FOR PART A AND PART B MONITORING RESULTS:
A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B.
TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO ❑
IF YES, HAVE YOU CONTACFEPJp,�IHE DEMLR REGIONAL OFFICE`?, YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME: ,�V,7z 9&(r, Al 6,0
Mail an original copy of this DMR including all No Discharge" reports within 30 days of receipt of the lab results (or at end of monitoring period in the
case of "No Discharge" reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617 Y
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I
am aware that there are siWificantpelpties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
of Pe ee 0' Date
Permit Date:11/1/2018-5/31/2021
SWU-248, last revised 11/1/2018
Page 2 of 2

ST.ORMWATER DISCHARGE OUTFALL (SDO)
ANNUAL SUMMARY DATA MONITORING REPORT (D ? / $P P Annual Update DATA REVIEW FORM
Calendar Year <
Individual NPDES Permit No.
Certificate of Coverage.(COC) No.
or
This monitoring report summary of the calendar year should be kept on file on -site with the facility SPPP.
Facility Name:
County: Ile -
Phone Number: d=
Outfall No.
Total no. of SDOs monitored
Is this outfall currently in Tier 2 (monitored monthly)?
Was this outfall ever in Tier 2 (monitored monthly) during the past year?
If this outfall was in Tier 2 last year, why was monthly monitoring discontinued?
Enough consecutive samples below benchmarks to decrease frequency ❑
Received approval from DWQ to reduce monitoring frequency ❑❑
Other
Was this SDO monitored because of vehicle maintenance activities?
Yes No ❑
Yes ❑ No
No ❑

Additional Outfall Attachment
Outfall No.
Is this outfall currently in Tier 2 (monitored monthly)? Yes ❑ No ❑
Was this outfall ever in Tier 2 (monitored monthly) during the past year? Yes ❑ No ❑
If this outfall was in -Tier 2 last year, why was monthly monitoring discontinued?
Enough consecutive samples below benchmarks to decrease frequency ❑
Received approval from DWQ to reduce monitoring frequency ❑
Other _ ❑
Was this SDO monitored because of vehicle maintenance activities? Yes ❑ No ❑
M
ter�.tonrts)a�:,a.;;s
a
r
�� y.
,w cx. w'
r
yn >v:•.zr�E"4
'-. 5
A v�.gg5�
Benchmark
s-'MIA-
Date Sample
mm/ddtyy
x
.,...
r
,.
±,c :-
_
SWU-264 - Generic Annual DMR
Last mvised W 1/1018

"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a
system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person
or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the
best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information,
including the possibility of f"n�nd impasonment for knowing violations."
Date
For questions, contact your local Regional Office:
DEMLR Reqional Office Contact Information:
2090 US Highway 70
225 Green Street
610 East Center Avenue/Suite 301
Swannanoa, NC 28778
Systel Building Suite 714
Mooresville, NC 28115
[phone]
Fayetteville, NC 28301-5043
[phone]
(910)4.3 -3 00 —
—
— --
r._3
:REGCU3O .
R' AIVRiO1�Fr1IiOP
3800 Barrett Drive
943 Washington Square Mall
I 127 Cardinal Drive Extension
Raleigh, NC 27609
Washington, NC 27889
Wilmington, NC 28405-2845
[phone]
[phone]
[phone]
---------- -- -- --
-
1617 Mail Service Center
450 Hanes Mill Rd, Suite 300
Winston-Salem, NC 27105
Raleigh, NC 27699-1617
336 776-9800
[phone]
SWU-264 - Generic Annual DMR
Last revised 6(012018

Fast Bus
Mr. Juan Larrequi
455 Grove Street
Fayetteville, NC 28302
�VMICROBAC@
Microbac Laboratories, Inc. - Fayetteville
CERTIFICATE OF ANALYSIS
K900085
Project Name: Fast Bus
Project / PO Number: N/A
Received: 07/08/2019
Reported: 07/18/2019
Analytical Testing Parameters ,1
Client Sample ID: Stormwater, Grab
Sample Matrix: Stormwater Collected By: Client
Lab Sample ID: K9G0085-01 Collection Date: 07/08/2019 13:37
Wet Chemistry Result RL Units Dilution Note Prepared Analyzed Analyst
EPA 1664 Rev. B
Oil & Grease (HEM) 6.7 5.0 mglL 1 07/15/19 0900 TAB '
SM 2540 D-2011
Total Suspended Solids
Definitions
RL:
Reporting Limit
139 % 5.00 mg/L 1
Project Requested Certification(s)
Microbac Laboratories, Inc. - Fayetteville
11 North Carolina DENR NPDES
07/09/19 1014 CLB
,11�aIlq
Report Commentseviewed and Approved By:
Samples were re ed in proppnss
nd the ooed resultsZon'm o G/��L/LL rlcPiL
applicable accr ation standaat;
noted.
The data and information on thia companying documents,represents
only the sample(s) analyzed. This report is incomplete unless all pages indicated Jeanne Overstreet
in the footnote are present and an authorized signature is included. Client Relationship Specialist, Environmental
Reported: 07/18/2019 10:15
Microbac Laboratories, Inc.
2592 Hope Mills Rd I Fayetteville, NC 28306 1910.864.1920 p I w .microbac.com Pd9e 1 Of 2

w
`K9G0085`
Mlcroheo-Fayettevllla SHORTH01 DSACCEPTEDMONDAY.THURSDAYUN77LIsoo
(QMICROBAC" use Hope Mills Rd. CHAIN OF CUSTODY RECO',
Fayettavllls, NC MUM
Number--
' In4uctions on back
Cllant Name: Turnaround —
Lab ReportAddrass Invoice Address Tlme TO BE COMAE!'c,_D BY MlCROBAC
,p
Addrese: Client Name: GG Routine (5 to 7 business days) Temp. Upon Receipt (°Cj/.5- Therm M
CI tyZi f S� Address: [] RUSW(notify lab) Holdtug Tlme
te, p: ! C L City, state, , Zip; S��G/r (needed by) Samples Received on Ice? Yes No WA ^,ja.GfP
Tale hone No.; QContact: - - Reportiype CustodySeals lntrcs Intact? No WA
-----, 7elaphana No., p,L/ P _ _Resu_It_s_Only I ] Levef 1 I ] LeveI2.I ] Level3 [ ] Lave14_I ] EPD
5_end R�art via: �Mell _ (r] F:oc Amall 9entl I_rnolce yla: Mall Fax e-mail
"i �0n' PO No.. _ _ Com Iianca Montfarin Yes No A enc /P
---• .�J� ll/cil�l.. P..... s3.1.].__U_._i.l_s i- _.._.
Sampled bx(p7ylN7�,• / 0 � Sem ers nature: _ .-.PI_ !6- Sampler Phena No,l
•_P�sserva!,Ive�ea; SoWSOIItl (S), Slud9e, OII, Wipe, Ddnldng Water (DW), Groundwater (GW}, enders Water (SW), Waste Vvater (WW), other (speWty) _

STORMWATER DISCHARGE OUTFALL (SDO)
ANNUAL SUMMARY DATA MONITORING REPORT (Di SK Annual Update DATA REVIEW FORM
Calendar Year
Individual NPDES Permit No.
f C vera a (COC) No
Fell
JUL 1 7 2019
Certificate o o g ••----- - CENT
PPP.
This monitoring report summary of the calendar year should be kept on file on -site 10
Facility Name:
County: l �? 31
_J Total no of SDOs monitored
Phone Number
Outfall No.
YesK No ❑
Is this outfall currently in Tier 2 (monitored monthly)?
Yes El NoRl
Was this outfall ever in Tier 2 (monitored monthly) during the past year?
If this outfall was in Tier 2 last year, why was monthly monitoring discontinued?
Enough consecutive samples below benchmarks to decrease frequency ❑❑
Received approval from DWQ to reduce monitoring frequency ❑
Other
Yes No ElWas this SDO monitored because of vehicle maintenance activities?

' +w
Additional (]utfaUAttachment
Outfall No.
Is this outfall currently in Tier 2 (monitored monthly)? Yes El No El
Was this outfall ever in Tier 2 (monitored monthly) during the past year? Yes E] No [I
If this outfall was in Tier 2 last year, why was monthly monitoring discontinued?
Enough consecutive samples below benchmarks to decrease frequency F-1
Received approval from DWQ to reduce monitoring frequency F-1
Other
Was this SDO monitored because of vehicle maintenance activities? Yes Ej No E:1
SEEM
S0U-26^Generic Annual DMR

"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a
system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person
or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the
best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information,
including the possibility of fine impq;j pent for knowing violations."
Signature
Date
For questions, contact your local Regional Office:
DEMLR Regional Office Contact Information:
XS yIfS '' GIO .O ., -.
2090 US Highway 70
Y � • I2E NAIs @ •
ESV , -
225 Green Street
610 East Center Avenue/Suite 301
Swannanoa, NC 28778
Systel Building Suite 714
Mooresville, NC 28115
(828) 296A500
Fayetteville, NC 28301-5043
[phone]
[phone]
_
:N. .:_... A`�O
--� n-
3800 Barrett Drive
943 Washington Square Mall
127 Cardinal Drive Extension
Raleigh, NC 27609
Washington, NC 27889
Wilmington, NC 28405-2845
[phone]
[phone]
[phone]
-----------------
1617 Mail Service Center
450 Hanes Mill Rd, Suite 300
Winston-Salem, NC 27105
Raleigh, NC 27699-1617
336) 776-9800
[phone]
SWU-264 - Generic Annual DMR
Last revised 6/01/2018

Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Energy, Mineral andl.an ©eso2urc eneral Permit No. NCG080000
Date submitted (p
CERTIFICATE OF CG NCGO8
FACILITY NAME
UNTY
PERSON COLLECTING MPLE�� LL4_1 (
LABORATORY /y�� Lab Cert. #
Comments on sample GolleGtipn or analysis: r
w /iv AA .. ,. �,. L f /.� AP Lo..s ni�ii/
SAMPLE COLLECTION YEAR
SAMPLE PERIOD X Jan -June ❑ July -Dec •
or Z] Monthly'/A / /e► (month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑P.NA
oOttieflow ❑Water Supply [:]SARECEIVED,
JUL 17 2019 PLEASE REMEMBER TO SIGN ON THE REVERSE 4 .
®(�j6/,t/G/Yb/ulk/ cur/!/!l //�.cat�7• CENTRAL FILES
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons ofQ1r?l�o0$GTrQh1h?ffiyes ❑ no if es complete Part A)
Part A: Vehicle & Equipment Maintenance Areas Monitoring Requirements (If applicable) 4 No discharge this period
-,gate sam le'Collectedt
- P dlyr)=
. -
24-hour rainfall amount
;Inches'
465.29
: 'Non Polar Oil& Gfease -
.w„ mg/L >fx _ '.::�:;mg/L•
00552.
Totai Suspended solids,New
..
100 or SW
c�_._ C0530 ,
Motor o Hydraulic Oil Usage,
$. . al man .. .
- NCOIL
Outfall No...
Benchmarks
Parameter Code.'
fnr4l.P .MP
narameteratthe same outfall.
1 Monthly sampling (instead of semi-annual) must begin wren Ene second cun�eLuuv= " ^ _ ••-- •-• - - -
1 For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
'The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement.
° See General Permit text, Table 1, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Note: Results must be reported in numerical format. For example do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -
numerical format. When results are below the applicable limits, they must be reported in the format, "<XX mgjL", where XX is the numerical value ofthe
detection limit, reporting limit, etc. in mg/L. Conversely, where fecal coliform results exceed the dilution upper limit, report the result as ">XX".
SWU-248, last revised 11/1/2018
Permit Date: 11/1/2018-5/31/2021 Page 1 of 2

f
' �� .
.1
,{
'•.
�.
-
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jt
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Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals (If applicable) 4 No discharge this periodz
'>Outfall s��/Date
i x
Sample"
`O,x
_Collected.-- s�amount,--.
`24hourramfall
r �. �r.,�nri
:•SampleColledtedi
xn:s k:.sk
mo/dd /y ,� �
x`+TotalSuspen8ed�r�,'"pH
....$nx,�
Sohds �
'` jX�',
mg/t: c4..
wS'---'Non-Polar
Zr� tZ.=✓,C
Standard untts
,
. s-,� - s�;
Oil`
- 5
,. Grease; �
, -mix.
. ,. , .. zeu 1
^PorameterCode��.6529_.,:%'�`.?s...�,�,>_,,,,
.ruu •, s<: .-,..�,z ....� ..:w
.rrsi.`�w, � .� ...,,sv:�"��..:
,�
z a.+ �� ,"
'. cj rr' m
TM�' '
1DD 07, 50•. �
.. STt A
.00530..:. ._
b 0
. ,,. 00400..E
�+, > %. 15, •,' , , �'t �'•
A• 9 t,
Footnotes from Part A also apply to this Part B
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. see General Permit text.
FOR PARTA AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO Q
IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE? YES Q NO 0
REGIONAL OFFICE CONTACT NAME:
Mail an original coav of this DMR, includinq all 'No Discharge" reports, within 30 do of receipt of the lab results for at end of monitoring period in the
case of "No Discharge" reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I
am aware that there are significant p"alties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
Date
Permit Date: 11/l/2018-5/31/2021 SWU-248, last revised 11/1/2018
Page 2 of 2